Shotz: Surgery #1

Shotz at the Veterinarian

Saturday, December 2, 2000: The day dawned cold and gray. Shotz loved winter; the cool weather invigorated her. She ripped around the backyard at top speed, happy to have so much room to run free. All morning we had asked her, “Well, what do you want for your sixth birthday?” If she could have answered, I’m sure she would’ve included a swim, even though the thermometer read barely twenty degrees.

Bundled up, my husband and I set to work to clean gutters, the channels overflowing with autumn leaves, cedar debris, and hickory nuts, some ready to sprout. After the morning cleanup, we had plans to take Shotz on a long walk along the trails at Bear Creek in Keller.

In the meantime, she was having a blast tearing through piles of leaves, scattering them everywhere, dragging logs off our woodpile, and dumping them on our back porch.

Years ago, we had terraced our side yard with railroad ties, and there I had planted my vegetable garden. But the only crop thriving in the rows that day was weeds. Once the gutters had been cleaned, weeding was next on our to-do list—but after we three celebrated Shotz’s birthday.

As she had numerous times, Shotz came flying around the corner of the house at record speed, made a U-turn at the pedestrian gate, and started back across this narrow section of lawn. As she reached the halfway point, she jumped onto the first tier of railroad ties, and from there onto the next until she reached the top tier. She leaped across the walkway that separated these two sections. When she landed, she let out an earsplitting cry that cut to my soul, then crumpled into a heap onto the grass.

My husband raced over to help her up, but she stood almost immediately, limped a few feet, then trotted off at a slow but deliberate pace, whining as she disappeared among the shrubs. He ran after her while I checked the area, trying to figure out why she had fallen, but saw nothing except a patch of ice atop one railroad tie. My main concern was to find her and see why she was limping.

I found Dave sitting next to her on the ground. She tried to stand but sat again, all the time whimpering softly. We hoped she had suffered only a bad sprain but later admitted we thought she might’ve broken the leg. However, neither one of us wanted to face that truth.

Dave was covered in mud and dirt from cleaning the gutters, so I agreed to take Shotz to the emergency clinic, less than a ten-minute drive from our house. She could walk, but as soon as we saw her dragging her right leg, Dave picked her up and carried her to our SUV while I went for my keys and wallet.

After waiting for what seemed like hours, the vet at the emergency clinic informed me that Shotz had torn her anterior cruciate ligament (ACL) and needed surgery. I could hardly believe what he was saying. He mentioned we’d need a referral from our personal veterinarian, since an orthopedic surgeon would have to do the procedure. I felt terrible for her.

Our vet referred us to Dr. Robert Barstad at the Dallas Veterinarian Surgical Center (DVSC) in McKinney. The center also had a satellite office in Southlake, which was right on the border with Keller and in the same building as the emergency clinic. The center, emergency clinic, and our veterinarian’s office were located next door to each other, which made the office visits convenient.

Then the wait began. We made an appointment for a consultation with Dr. Barstad (through our vet), but he couldn’t see Shotz until December 8. In the meantime, our vet prescribed a painkiller for her. The wait seemed worse for us than her; she managed to keep moving on three legs, occasionally hopping using the fourth, but she tired easily and wasn’t interested in play.

After the December 8 orthopedic examination, we did receive some positive news: Shotz had no signs of hip dysplasia and her overall health was excellent.

On December 13 I dropped her off at the surgical center in Southlake and cried all the way home, praying all would go well with the operation and her recuperation. A half hour or so into the surgery, Dr. Barstad called with unfortunate news: Shotz had not torn her ACL but had a “complete tear of her posterior cruciate ligament.”

Because of the PCL injury, Dr. Barstad suggested a modification of your typical tibial plateau leveling osteotomy (TPLO), an experimental procedure he felt would benefit her in the long term. However, he cautioned that the De Angelis repair had a poorer prognosis than a TPLO repair or an ACL procedure. I trusted him, so I gave him the okay to perform a reverse De Angelis repair.

In his December 14 notes to our vet, Dr. Barstad wrote: “80 # test monofilament nylon was placed through a tunnel in the fibular head, wound through the straight patellar tendon just distal to the patella, then down to a tunnel on the caudal/medial edge of the proximal tibial plateau. The simple loop configuration was tied in a taut position, advancing the tibia in an anterior direction. The gracilis muscle was freed and advanced forward onto the patella with tension pulling the tibia anterior. It was sutured at the patella with a reverse fascial band that we dissected free from the lateral retinaculum. These two dynamic advancement flaps provided additional cranial thrust when sutured to the straight patellar tendon. A routine closure was performed, and the leg was placed in a padded wrap.”

He also wrote: “I have seen fewer than 20 of these injuries in my career, and the majority of them [the patients] were hit by cars with the blow of the bumper being focused right on the kneecap. ‘Shotz’ evidently self-inflicted that type of force hitting the railroad tie. The reverse De Angelis repair will improve her function and stabilize the knee, but these dogs never do as well as ACL repairs. If we take it slow and start to swim at the 21-day point, hopefully we will achieve satisfactory function of the leg and hopefully consistent usage by 8-9 weeks.”

After the surgery, we followed Dr. Barstad’s recommendations for Shotz’s recovery to the letter, and all went well until February 24, 2001.

Next week: “Shotz: Surgery #2.”

 

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